9 results
15 - Social perspectives on diagnosis
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- By Peter Ferns, Thornton Heath, UK, Premila Trivedi, Thornton Heath, UK, Suman Fernando, London Metropolitan University, London, UK
- Edited by Kamaldeep Bhui
-
- Book:
- Elements of Culture and Mental Health
- Published by:
- Royal College of Psychiatrists
- Published online:
- 25 February 2017, pp 69-72
-
- Chapter
- Export citation
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Summary
Modern Western psychology and psychiatry arose in the context of the European Enlightenment of the 17th and 18th centuries. In the early 19th century, only two main mental illnesses were usually recognised – mania and melancholia (Shorter, 1997). As various theories of mental functioning came on the scene, new diagnoses were constructed in Europe and North America and two key diagnostic systems, the International Classification of Diseases (ICD) and Diagnostic and Statistical Manual of Mental Disorders (DSM), were developed. These are revised from time to time by groups of psychiatrists mainly living in the West and usually strongly influenced by pressure groups, including pharmaceutical companies wishing to market new remedies for illnesses. The first DSM (American Psychiatric Association, 1952) contained 60 diagnoses; the current edition, DSM-IV (American Psychiatric Association, 1994), lists 297; and DSM-5, to be published in 2013, is likely to have even more (American Psychiatric Association, 2010).
A few diagnoses have fallen by the wayside. For example, gone are several popularised in the southern states of the USA as peculiar to Black slaves, such as drapetomania, characterised by persistent running away from the plantations (Cartwright, 1851). Homosexuality was listed as an illness in the DSM until the seventh printing of DSM-IV in 1974 and in the ICD until ICD-10, published in 1990 (Shorter, 1997). Well into the 1960s, depression was reported as rare among Asian and African people and Black Americans, a rarity attributed to their supposed irresponsible nature (Green, 1914) and absence of a sense of responsibility (Carothers, 1953).
A multi-ethnic society includes people whose backgrounds are culturally diverse as well as people seen as different in terms of race. No psychiatric diagnosis has an established biological marker; hence, there is no way of proving objectively its accuracy or its validity as a measure of a biological reality applicable to all human beings. Kendell & Jablensky (2003) describe diagnostic categories as ‘simply concepts, justified only by whether they provide a useful framework for organizing and explaining the complexity of clinical experience in order to derive inferences about outcome and to guide decisions about treatment’. They warn against reifying a diagnosis by assuming that it is ‘an entity of some kind that can be evoked to explain the patient's symptoms and whose validity need not be questioned’.
13 - Do the power relations inherent in medical systems help or hinder in cross-cultural psychiatry?
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- By Peter Ferns, Thornton Heath, UK, Premila Trivedi, Thornton Heath, UK, Suman Fernando, London Metropolitan University, London, UK
- Edited by Kamaldeep Bhui
-
- Book:
- Elements of Culture and Mental Health
- Published by:
- Royal College of Psychiatrists
- Published online:
- 25 February 2017, pp 61-64
-
- Chapter
- Export citation
-
Summary
Power relations are a structural characteristic of all social relationships, organisational systems and societies as a whole (Proctor, 2002; Dalal, 2003). Certain identities are accorded different powers and status depending on who they are as people (societal, personal and historic power) and the position they hold within a hierarchical institution or work setting (role-power; authority). In medicine, doctors (because of their education, training, experience and expertise) have the authority to diagnose and treat those they deem to be ill, with clear boundaries, systems of accountability and opportunities for others to challenge those decisions if there are breaches of a doctor's defined roles. Less obvious perhaps is the societal, personal and historic powers exerted (often unwittingly) by doctors’ values, biases and assumptions about their patients, since subjectivity is part of the clinical task. These informal values and systemic biases are not easy to identify, not necessarily limited by any formal boundaries and have no regulated system of accountability, leaving their influence to the discretion of each individual clinician. This source of influence and power is of particular significance in psychiatry, where diagnosis and treatment are determined not by an objective measurement or scientific test or biomarker, but rather by professional judgements that make positive and creative use of subjectivity (Loring & Powell, 1988; Fernando, 2010).
Psychiatry is firmly located within medical systems of authority, developed (at least initially) within Western (Euro–American, industrialised and high-income) countries and cultures; within these cultures, doctors were allocated the authority to name problematic thoughts, feelings and behaviours as illness of the mind (see Chapter 14, this volume). However, aspects of these problematic thoughts, feelings and behaviours are culturally determined and they may fall outside psychiatry's Eurocentric frame of reference. They may, however, be acceptable within their relevant cultural contexts. In such situations, misunderstandings can easily occur when psychiatrists (wittingly or unwittingly) use not only authority but also power in a way that is at least partially determined by their personal values and biases to inform diagnosis, risk assessment, treatment and management (Loring & Powell, 1988). The effects of this can be very serious and reach far beyond the confines of medicine, since psychiatrists have the authority to use medical, social, psychological, behavioural and physical interventions (by coercion if they deem this necessary).
14 - Recovery and well-being: a paradigm for care
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- By Peter Ferns, Thornton Heath, UK, Premila Trivedi, Thornton Heath, UK, Suman Fernando, London Metropolitan University, London, UK
- Edited by Kamaldeep Bhui
-
- Book:
- Elements of Culture and Mental Health
- Published by:
- Royal College of Psychiatrists
- Published online:
- 25 February 2017, pp 65-68
-
- Chapter
- Export citation
-
Summary
The World Health Organization (2001: p. 3) defines health as ‘a state of complete physical, mental and social well-being’. What is meant to any individual by well-being, mental health and what constitute mental health problems, and to some extent mental illness, is largely determined by the cultural and social circumstances of communities in which the individual in most instances is immersed (Fernando, 2010). In multicultural situations, different interpretations exist side by side, but which ones dominate will be determined by the power relations that exist between the different cultural groups (see Chapter 13, this volume). The closest we can get to studying well-being and mental health as experienced by people in particular cultural/multicultural and social settings is therefore to explore not only the meanings that are given by each constituent community, but also how some meanings are privileged over others and how this can serve to diminish or invalidate others. By the same argument, the meaning of recovery from mental health problems must also be defined within specific cultural/multicultural and social contexts.
The terms well-being and mental health capture different concepts: the former encompasses personal, social and spiritual aspects of life and functioning in society, whereas the latter implies a biomedical understanding of how a person's mind functions. The focus on well-being has grown rapidly in recent years and is justified on the grounds that, in contrast to assessments of mental health by experts, well-being: (a) is based on standards and values chosen by people themselves; (b) reflects success or failure in achieving norms and values that people themselves seek; and (c) includes components dependent on pleasure and the fulfilment of basic human needs, but also includes people's ethical and evaluative judgements of their lives (Diener & Suh, 2000). At a personal level, well-being, sometimes called subjective well-being or happiness (Diener, 1984), is a positive state of mind brought about by satisfaction of personal, relational and collective needs (Prilleltensky et al, 2001). However, there is another approach (the capabilities approach) to well-being, which is more about what people can do as agents and are in terms of lived experience – the emphasis being on their having the capability (i.e. the practical choice) to function (Sen, 2008).
15 - Social perspectives on diagnosis
-
- By Premila Trivedi, Mental Health Service User, Trainer and Advisor, Thornton Heath, UK, Suman Fernando, Honorary Professor, Faculty of Social Sciences and Humanities, London Metropolitan University, London, UK, Peter Ferns, Training Consultant and Social Worker, Thornton Heath, UK
- Edited by Kamaldeep Bhui
-
- Book:
- Elements of Culture and Mental Health
- Published online:
- 01 January 2018
- Print publication:
- 01 January 2013, pp 69-72
-
- Chapter
- Export citation
-
Summary
Modern Western psychology and psychiatry arose in the context of the European Enlightenment of the 17th and 18th centuries. In the early 19th century, only two main mental illnesses were usually recognised – mania and melancholia (Shorter, 1997). As various theories of mental functioning came on the scene, new diagnoses were constructed in Europe and North America and two key diagnostic systems, the International Classification of Diseases (ICD) and Diagnostic and Statistical Manual of Mental Disorders (DSM), were developed. These are revised from time to time by groups of psychiatrists mainly living in the West and usually strongly influenced by pressure groups, including pharmaceutical companies wishing to market new remedies for illnesses. The first DSM (American Psychiatric Association, 1952) contained 60 diagnoses; the current edition, DSMIV (American Psychiatric Association, 1994), lists 297; and DSM-5, to be published in 2013, is likely to have even more (American Psychiatric Association, 2010).
A few diagnoses have fallen by the wayside. For example, gone are several popularised in the southern states of the USA as peculiar to Black slaves, such as drapetomania, characterised by persistent running away from the plantations (Cartwright, 1851). Homosexuality was listed as an illness in the DSM until the seventh printing of DSM-IV in 1974 and in the ICD until ICD-10, published in 1990 (Shorter, 1997). Well into the 1960s, depression was reported as rare among Asian and African people and Black Americans, a rarity attributed to their supposed irresponsible nature (Green, 1914) and absence of a sense of responsibility (Carothers, 1953).
A multi-ethnic society includes people whose backgrounds are culturally diverse as well as people seen as different in terms of race. No psychiatric diagnosis has an established biological marker; hence, there is no way of proving objectively its accuracy or its validity as a measure of a biological reality applicable to all human beings. Kendell & Jablensky (2003) describe diagnostic categories as ‘simply concepts, justified only by whether they provide a useful framework for organizing and explaining the complexity of clinical experience in order to derive inferences about outcome and to guide decisions about treatment’. They warn against reifying a diagnosis by assuming that it is ‘an entity of some kind that can be evoked to explain the patient's symptoms and whose validity need not be questioned’.
Incorporation of Luminescent Zinc Oxide Nanoparticles into Polystyrene
- Rui Li, George R. Fern, Robert Withnall, Jack Silver, Peter Bishop, Benedicte Thiebaut
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- Journal:
- MRS Online Proceedings Library Archive / Volume 1509 / 2013
- Published online by Cambridge University Press:
- 10 April 2013, mrsf12-1509-cc03-17
- Print publication:
- 2013
-
- Article
- Export citation
-
Zinc oxide (ZnO) nanoparticles and nanoparticles of luminescent zinc oxide (ZnO:Zn) phosphor were successfully synthesised and well characterised. A transparent polystyrene composite sheet containing ZnO:Zn nanoparticles was prepared by a solvent casting method. The sheet manifested comparable transmission to a virgin polystyrene film due to very uniform dispersion of the ZnO:Zn nanoparticles into the polystyrene. Evidence for uniform dispersion was evident in both its luminescent properties and in a SEM image. The photoluminescent characteristics of the ZnO:Zn, both as a pure powder and embedded in a polystyrene matrix, are reported. The uniformity of the photoluminescence of the composite sheet under near ultraviolet excitation is demonstrated. The luminescent ZnO:Zn nanoparticles are shown to have applications for use not only as an inhibitor of the ultraviolet degradation of polymers, but also for providing polymers with light emitting functionality.
13 - Do the power relations inherent in medical systems help or hinder in cross-cultural psychiatry?
-
- By Peter Ferns, Training Consultant and Social Worker, Thornton Heath, UK, Premila Trivedi, Mental Health Service User, Trainer and Advisor, Thornton Heath, UK, Suman Fernando, Honorary Professor, Faculty of Social Sciences and Humanities, London Metropolitan University, London, UK
- Edited by Kamaldeep Bhui
-
- Book:
- Elements of Culture and Mental Health
- Published online:
- 01 January 2018
- Print publication:
- 01 January 2013, pp 61-64
-
- Chapter
- Export citation
-
Summary
Power relations are a structural characteristic of all social relationships, organisational systems and societies as a whole (Proctor, 2002; Dalal, 2003). Certain identities are accorded different powers and status depending on who they are as people (societal, personal and historic power) and the position they hold within a hierarchical institution or work setting (role-power; authority). In medicine, doctors (because of their education, training, experience and expertise) have the authority to diagnose and treat those they deem to be ill, with clear boundaries, systems of accountability and opportunities for others to challenge those decisions if there are breaches of a doctor's defined roles. Less obvious perhaps is the societal, personal and historic powers exerted (often unwittingly) by doctors’ values, biases and assumptions about their patients, since subjectivity is part of the clinical task. These informal values and systemic biases are not easy to identify, not necessarily limited by any formal boundaries and have no regulated system of accountability, leaving their influence to the discretion of each individual clinician. This source of influence and power is of particular significance in psychiatry, where diagnosis and treatment are determined not by an objective measurement or scientific test or biomarker, but rather by professional judgements that make positive and creative use of subjectivity (Loring & Powell, 1988; Fernando, 2010).
Psychiatry is firmly located within medical systems of authority, developed (at least initially) within Western (Euro–American, industrialised and high-income) countries and cultures; within these cultures, doctors were allocated the authority to name problematic thoughts, feelings and behaviours as illness of the mind (see Chapter 14, this volume). However, aspects of these problematic thoughts, feelings and behaviours are culturally determined and they may fall outside psychiatry's Eurocentric frame of reference. They may, however, be acceptable within their relevant cultural contexts. In such situations, misunderstandings can easily occur when psychiatrists (wittingly or unwittingly) use not only authority but also power in a way that is at least partially determined by their personal values and biases to inform diagnosis, risk assessment, treatment and management (Loring & Powell, 1988).
14 - Recovery and well-being: a paradigm for care
-
- By Suman Fernando, Honorary Professor, Faculty of Social Sciences and Humanities, London Metropolitan University, London, UK, Premila Trivedi, Mental Health Service User, Trainer and Advisor, Thornton Heath, UK, Peter Ferns, Training Consultant and Social Worker, Thornton Heath, UK
- Edited by Kamaldeep Bhui
-
- Book:
- Elements of Culture and Mental Health
- Published online:
- 01 January 2018
- Print publication:
- 01 January 2013, pp 65-68
-
- Chapter
- Export citation
-
Summary
The World Health Organization (2001: p. 3) defines health as ‘a state of complete physical, mental and social well-being’. What is meant to any individual by well-being, mental health and what constitute mental health problems, and to some extent mental illness, is largely determined by the cultural and social circumstances of communities in which the individual in most instances is immersed (Fernando, 2010). In multicultural situations, different interpretations exist side by side, but which ones dominate will be determined by the power relations that exist between the different cultural groups (see Chapter 13, this volume). The closest we can get to studying well-being and mental health as experienced by people in particular cultural/multicultural and social settings is therefore to explore not only the meanings that are given by each constituent community, but also how some meanings are privileged over others and how this can serve to diminish or invalidate others. By the same argument, the meaning of recovery from mental health problems must also be defined within specific cultural/multicultural and social contexts.
The terms well-being and mental health capture different concepts: the former encompasses personal, social and spiritual aspects of life and functioning in society, whereas the latter implies a biomedical understanding of how a person's mind functions. The focus on well-being has grown rapidly in recent years and is justified on the grounds that, in contrast to assessments of mental health by experts, well-being: (a) is based on standards and values chosen by people themselves; (b) reflects success or failure in achieving norms and values that people themselves seek; and (c) includes components dependent on pleasure and the fulfilment of basic human needs, but also includes people's ethical and evaluative judgements of their lives (Diener & Suh, 2000). At a personal level, well-being, sometimes called subjective well-being or happiness (Diener, 1984), is a positive state of mind brought about by satisfaction of personal, relational and collective needs (Prilleltensky et al, 2001). However, there is another approach (the capabilities approach) to well-being, which is more about what people can doas agents and arein terms of lived experience – the emphasis being on their having the capability (i.e. the practical choice) to function (Sen, 2008).
Contributors
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- By Nalini Vadivelu, Christian J. Whitney, Raymond S. Sinatra, M. Khurram Ghori, Yu-Fan (Robert) Zhang, Raymond S. Sinatra, Joshua Wellington, Yuan-Yi Chia, Francis J. Keefe, Jon McCormack, Ian Power, John Butterworth, P. M. Lavand’homme, M. F. De Kock, Bradley Urie, Oscar A. de Leon-Casasola, Frederick M. Perkins, Larry F. Chu, David Clark, Martin S. Angst, Cynthia M. Welchek, Lisa Mastrangelo, Raymond S. Sinatra, Richard Martinez, Scott S. Reuben, Asokumar Buvanendran, Raymond S. Sinatra, Pamela E Macintyre, Julia Coldrey, Daniel B. Maalouf, Spencer S. Liu, Susan Dabu-Bondoc, Samantha A. Franco, Raymond S. Sinatra, James Benonis, Jennifer Fortney, David Hardman, Gavin Martin, Holly Evans, Karen C. Nielsen, Marcy S. Tucker, Stephen M. Klein, Benjamin Sherman, Ikay Enu, Raymond S. Sinatra, James W. Heitz, Eugene R. Viscusi, Jonathan S. Jahr, Kofi N. Donkor, Raymond S. Sinatra, Manzo Suzuki, Johan Raeder, Vegard Dahl, Stefan Erceg, Keun Sam Chung, Kok-Yuen Ho, Tong J. Gan, Dermot R. Fitzgibbon, Paul Willoughby, Brian E. Harrington, Joseph Marino, Tariq M. Malik, Raymond S. Sinatra, Giorgio Ivani, Valeria Mossetti, Simona Italiano, Thomas M. Halaszynski, Nousheh Saidi, Javier Lopez, Kate Miller, Ferne Braveman, Jaya L. Varadarajan, Steven J. Weisman, Sukanya Mitra, Raymond S. Sinatra, Theodore J. Saclarides, Knox H. Todd, James R. Miner, Chris Pasero, Nancy Eksterowicz, Margo McCaffery, Leslie N. Schechter, Amr E. Abouleish, Govindaraj Ranganathan, Tee Yong Tan, Stephan A. Schug, Marie N. Hanna, Spencer S. Liu, Christopher L. Wu, Craig T. Hartrick, Garen Manvelian, Christine Miaskowski, Brian Durkin, Peter S. A. Glass
- Edited by Raymond S. Sinatra, Oscar A. de Leon-Cassasola, University of Rochester Medical Center, New York, Eugene R. Viscusi, Brian Ginsberg
- Foreword by Henry McQuay
-
- Book:
- Acute Pain Management
- Published online:
- 26 October 2009
- Print publication:
- 27 April 2009, pp vii-xii
-
- Chapter
- Export citation
Intake rates and the functional response in shorebirds (Charadriiformes) eating macro-invertebrates
- John D. Goss-Custard, Andrew D. West, Michael G. Yates, Richard W. G. Caldow, Richard A. Stillman, Louise Bardsley, Juan Castilla, Macarena Castro, Volker Dierschke, Sarah. E. A. Le. V. dit Durell, Goetz Eichhorn, Bruno J. Ens, Klaus-Michael Exo, P. U. Udayangani-Fernando, Peter N. Ferns, Philip A. R. Hockey, Jennifer A. Gill, Ian Johnstone, Bozena Kalejta-Summers, Jose A. Masero, Francisco Moreira, Rajarathina Velu Nagarajan, Ian P. F. Owens, Cristian Pacheco, Alejandro Perez-Hurtado, Danny Rogers, Gregor Scheiffarth, Humphrey Sitters, William J. Sutherland, Patrick Triplet, Dave H. Worrall1, Yuri Zharikov, Leo Zwarts, Richard A. Pettifor
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- Journal:
- Biological Reviews / Volume 81 / Issue 4 / November 2006
- Published online by Cambridge University Press:
- 24 July 2006, pp. 501-529
- Print publication:
- November 2006
-
- Article
- Export citation
-
As field determinations take much effort, it would be useful to be able to predict easily the coefficients describing the functional response of free-living predators, the function relating food intake rate to the abundance of food organisms in the environment. As a means easily to parameterise an individual-based model of shorebird Charadriiformes populations, we attempted this for shorebirds eating macro-invertebrates. Intake rate is measured as the ash-free dry mass (AFDM) per second of active foraging; i.e. excluding time spent on digestive pauses and other activities, such as preening. The present and previous studies show that the general shape of the functional response in shorebirds eating approximately the same size of prey across the full range of prey density is a decelerating rise to a plateau, thus approximating the Holling type II (‘disc equation’) formulation. But field studies confirmed that the asymptote was not set by handling time, as assumed by the disc equation, because only about half the foraging time was spent in successfully or unsuccessfully attacking and handling prey, the rest being devoted to searching.
A review of 30 functional responses showed that intake rate in free-living shorebirds varied independently of prey density over a wide range, with the asymptote being reached at very low prey densities (<150/m−2). Accordingly, most of the many studies of shorebird intake rate have probably been conducted at or near the asymptote of the functional response, suggesting that equations that predict intake rate should also predict the asymptote.
A multivariate analysis of 468 ‘spot’ estimates of intake rates from 26 shorebirds identified ten variables, representing prey and shorebird characteristics, that accounted for 81% of the variance in logarithm-transformed intake rate. But four-variables accounted for almost as much (77.3%), these being bird size, prey size, whether the bird was an oystercatcher Haematopus ostralegus eating mussels Mytilus edulis, or breeding. The four variable equation under-predicted, on average, the observed 30 estimates of the asymptote by 11.6%, but this discrepancy was reduced to 0.2% when two suspect estimates from one early study in the 1960s were removed. The equation therefore predicted the observed asymptote very successfully in 93% of cases.
We conclude that the asymptote can be reliably predicted from just four easily measured variables. Indeed, if the birds are not breeding and are not oystercatchers eating mussels, reliable predictions can be obtained using just two variables, bird and prey sizes. A multivariate analysis of 23 estimates of the half-asymptote constant suggested they were smaller when prey were small but greater when the birds were large, especially in oystercatchers. The resulting equation could be used to predict the half-asymptote constant, but its predictive power has yet to be tested.
As well as predicting the asymptote of the functional response, the equations will enable research workers engaged in many areas of shorebird ecology and behaviour to estimate intake rate without the need for conventional time-consuming field studies, including species for which it has not yet proved possible to measure intake rate in the field.
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